Still falling asleep at the wheel.....

elazarus · Post by **elazarus** » Mon Jun 04, 2007 10:27 pm

Hi, I am new to this forum....You folks are doing a great service and great job.

After 2 CPAP tests it was determined that I have had OSA for ages. I started on a ResMed S8 with humidifier on May 18th.

10 days later I changed the masks for a different Nasal mask and a different Nasal pillow setup. So far nothing and I know about Sleep deficit.

The morning after my 2nd Sleep test I awakened fully refreshed. Since I started the use of the machine at home...zero mornings awakening refreshed and still fighting to stay awake while driving.

The masks fit. The machine works......It is set at 8 with a ramp of 20 minutes......but shouldn't I feel even a teeny bit refreshed in the morning? This is quite frustrating.

I spend an hour a day looking for new masks as I am searching for the perfect fit (no such thing) and something that will work.

Any thoughts?

Thank you

blarg · Post by **blarg** » Tue Jun 05, 2007 1:12 am

It does take some real time to recover from the sleep deficit that you've been running for all these years.

It could also be that the pressure isn't ideal, or you're experiencing mouth leaking. Could you post your leak and AHI statistics?

gill · Post by **gill** » Tue Jun 05, 2007 2:07 am

Hi There
I too have had OSA for years, and have been on CPAP since January. I have an s* just like you. I agree it's a struggle to find the right mask to fit you, but hang in there, the guys on this forum are great, and you will get some good advice here.

I'm just about waking up feeling ok, after nearly 6 months, so all I can say, is keep going, and listen to the advice you get here, these guys have saved my life many a time!

Just as an aside, I am from the U.K, and they automatically take your driving licence away when you are diagnosed with OSA, I had to wait 3 months for a CPAP machine because of our system here. It was 6months in total that I was without my licence. Torture!

Good Luck, keep on keeping on!

Gill

THier · Post by **THier** » Tue Jun 05, 2007 3:23 am

I still have day time sleepiness issues,, Doc prescribed "Provigil" , I don't use it everyday,, but it does help.

Tom

Craig-Tx · Post by **Craig-Tx** » Tue Jun 05, 2007 4:38 am

I started my therapy in January. I personally didn't have too much difficulty adjusting to the machine, but it was still several weeks, if not a couple of months before I could say I was feeling a difference. I will tell you, for me the second week, I felt worse than ever, even worse than my pre-cpap days. Also, like you the morning after the titration study I felt GREAT. It's probably that one night that kept me going through the harder times. I knew it would work, just had to give it time.

It's a common belief on this board that years of untreated sleep apnea builds up what we call a "sleep debt." Once treatment begins, you have to basically pay back your debt before you begin to move into the positive. For some people it may only take a few weeks to bounce back, for some it may take months.

That is of course if your treatment is working properly. If you were prescribed a pressure that isn't enough to treat your condition, then you are not effectively treating the apneas. If you are having problems with leaks due to mask issue or possibly "mouth breathing", then you again aren't getting the full treatment pressure to properly treat the condition.

Good Luck. And stick around. There is an abundance knowledge in this place.

Slinky · Post by **Slinky** » Tue Jun 05, 2007 7:45 am

elazarus, there are several models of Resmed S8s. The S8 Compact and S8 Escape are capable of compliance data only .

The S8 Elite and S8 AutoSet Vantage are fully data capable. With these machines one see and read their average pressure, average leak rate, AHI, AI and HI for the night. One is then better able to determine whether it is "sleep debt", ill fitting mask or incorrect pressure that is accounting for the lack of feeling rested.

Check your machine. If it is the Compact or Escape, contact the doctor who wrote the order for your machine and ask if he is aware that you were given a bare bones, compliance data only machine and how he can possibly monitor your therapy and make any adjustments that might be necessary w/o access to your nightly data or isn't he interested in monitoring your response to xPAP therapy. Tell him how great you felt the morning of your titration study and ask why you don't feel that rested after 2 weeks on xPAP therapy. Ask him shouldn't you feel even a teeny bit refreshed in the morning? Tell him this is quite frustrating for you.

You may get lucky and he'll rewrite your order for a fully data capable xPAP.

If you truly are still as sleepy as your subject title implies WHY ON EARTH are you still driving? Don't you have any care or consideration for the safety of the other drivers on the road and the pedestrians? I sure hope you don't have passengers in the car with you!!!

odawa · Post by **odawa** » Tue Jun 05, 2007 8:46 am

I hope you feel better soon. I got a new mask and that works wonders for me. I'm a side and front sleeper and the pillow kept moving the mask I had. I use the breeze and I have been sleeping alot better. Stay with it. I found persistence does pay off!!! Also all of the wonderful advice from everyone on this site is just amazing.
Good luck

Goofproof · Post by **Goofproof** » Tue Jun 05, 2007 10:02 am

As blarg said, you could and probably are losing your treatment pressure out of your mouth. a FF Mask or taping are the answer. It also takes the correct pressure and time to catch up, but if you don't seal that third hole nothing works.

In the interest of safety and better sleep, take that wheel off and put it in bed besides you, then we can all sleep better. Jim

Slinky · Post by **Slinky** » Tue Jun 05, 2007 2:20 pm

OOOOooooops!!!! I WAS WRONG. My mistake. I apologize for the misleading information. The Resmed S8 Escape IS fully data capable. It is the Resmed S8 Compact that is NOT fully data capable. My apologies for the erroneous information.

Machines in the Resmed S8 product line:

High End - S8 Vantage
[]Software, Auto-Adjust
Mid-High End - S8 Elite
[]Software, No Auto Adjust, EPR
Mid-Range - S8 Escape
[]Software, No Auto Adjust, No EPR
Entry Level - S8 Compact
[]Basic machine, No DC option

Mark_Ferman · Post by **Mark_Ferman** » Tue Jun 05, 2007 2:41 pm

I know what you mean. I was on the machine for about a month, some days were good, some days were not so good. But now after being on it for almost 2 months, I can say things are much better. In fact family and friends told me almost immediately that my color was much better (not grey anymore) and it was nice that I didn't fall asleep while talking to them (and that was when I thought IT WASN'T WORKING). For whatever reason, it does take time.

I have never had any other mask except for the one I am using, so I can't swear by it, but I do know I have little to no leaks at all with my mask, but it is a FULL FACE Mask.

Best of luck - (check your numbers if you can, because it may be things aren't right just yet).

DeltaSeeker · Post by **DeltaSeeker** » Tue Jun 05, 2007 2:55 pm

elazarus,

Welcome! I'm just shy of my 2 month point and had my first morning where I felt good today!!! (see post "I feel good!")

I must admit the headaches lessened almost right away and I'm still in search of the perfect mask/perfect setting, etc. but all that takes time. I'm one of those "I want it yesterday" types and it was very difficult for me to accept that I wasn't going to have one of those experiences like some do of putting on the mask and feeling good from day 1.

One good day makes up for all the "bad" or mediocre ones. It really gives you hope

Keep on hosin' dude...

Slinky · Post by **Slinky** » Tue Jun 05, 2007 2:56 pm

elazarus, if you have an S8 other than the Compact, try pushing down the Left and Right buttons at the same time and holding them for 3-4 seconds or so BEFORE NOON.

The LED screen should then read Efficacy Data. Press the Left button to Enter. That should tell you your average pressure for the night. Press the Down button. That should tell you your average Leak rate for the night. Press the Left button again. That should tell you the average Leak rate for the past week. And THAT info should help the experienced PAPpers in this forum determine if you are having problems w/mouth breathing or not.

Continuing w/pressing the Down button should get you your AHI, AI and HI and that might explain your lack of restful sleep.

Don't worry. This info is just data from the Advanced or Detailed Patient Menu. There is nothing you can do in this menu to alter your therapy or mess up any settings. The patient just usually isn't given access to this Menu unless the ordering doctor specifically orders its access.

The reason you must do this BEFORE NOON is because these xPAPs have an internal clock that runs from noon to noon. If you check after noon the daily stats will be gone from access via the LED screen and rolled over into the weekly stats.

Jefe · Post by **Jefe** » Tue Jun 05, 2007 2:58 pm

I won't get on the road when there is a chance I might fall asleep & hurt someone. My conscience couldn't handle that kind of pain.

Please reconsider driving when you feel that tired. If not for your own safety, please do it for ours.

elazarus · Post by **elazarus** » Tue Jun 05, 2007 5:57 pm

Thank you for answering.

I may have been a bit over dramatic about the falling asleep while driving.....although I went to have my teeth cleaned today and I fell asleep in the chair.

The ResMed that I have is the S8 Escape( one setting) with the HumidAire 3i. The mask in the hospital sleep study was a nasal mask which I am on my second one, the first one was too binding.

I must be sleeping with my mouth open and the reduces (eliminates?) the pressure which is set at 8. Maybe a Full face mask will help...I am not sure. Many nights I wake up and switch masks as the nasal gets uncomfortable and I switch to the pillows.

Will check the readout before noon tomorrow......and explore Full Masks...

Regards

Elliot

Craig-Tx · Post by **Craig-Tx** » Tue Jun 05, 2007 6:52 pm

If you often wake up with a dry mouth, then that is a very good sign that you are "mouth breathing." If your mouth opens and the pressurized air escapes through your mouth, then you aren't getting any treatment.

A Full Face mask is a good option. Chin Straps work for some people. Some others have begun to tape their mouths shut each night. There are a lot of topics here regarding taping.

I'm personally just lucky I guess. My tongue seems to completely block my throat. I don't even have to keep my mouth closed. (Perhaps this is why I have Apneas in the first place???) So far 6 months and no problems with mouth breathing.

Still falling asleep at the wheel.....

Still falling asleep at the wheel.....

still falling asleep at the wheel

frustrated... but... better now.